WO2023012708A1 - Ensemble électrode pour l'application de champs de traitement de tumeurs (ttchamps) comprenant une feuille de graphite - Google Patents

Ensemble électrode pour l'application de champs de traitement de tumeurs (ttchamps) comprenant une feuille de graphite Download PDF

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Publication number
WO2023012708A1
WO2023012708A1 PCT/IB2022/057234 IB2022057234W WO2023012708A1 WO 2023012708 A1 WO2023012708 A1 WO 2023012708A1 IB 2022057234 W IB2022057234 W IB 2022057234W WO 2023012708 A1 WO2023012708 A1 WO 2023012708A1
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WIPO (PCT)
Prior art keywords
sheet
layer
front face
electrode element
electrode
Prior art date
Application number
PCT/IB2022/057234
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English (en)
Inventor
Yoram Wasserman
Stas OBUCHOVSKY
Nataliya KUPLENNIK
David Shapiro
Original Assignee
Novocure Gmbh
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Novocure Gmbh filed Critical Novocure Gmbh
Priority to CN202280049637.2A priority Critical patent/CN117642208A/zh
Priority to KR1020237044278A priority patent/KR20240041872A/ko
Priority to CA3226310A priority patent/CA3226310A1/fr
Priority to MX2023015427A priority patent/MX2023015427A/es
Priority to EP22757666.7A priority patent/EP4344415A1/fr
Priority to JP2023579833A priority patent/JP2024527712A/ja
Priority to IL309481A priority patent/IL309481A/en
Publication of WO2023012708A1 publication Critical patent/WO2023012708A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36002—Cancer treatment, e.g. tumour
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K39/0005—Vertebrate antigens
    • A61K39/0011—Cancer antigens
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/0404—Electrodes for external use
    • A61N1/0472—Structure-related aspects
    • A61N1/0476—Array electrodes (including any electrode arrangement with more than one electrode for at least one of the polarities)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/0404—Electrodes for external use
    • A61N1/0472—Structure-related aspects
    • A61N1/0492—Patch electrodes
    • A61N1/0496—Patch electrodes characterised by using specific chemical compositions, e.g. hydrogel compositions, adhesives
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014—External stimulators, e.g. with patch electrodes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014—External stimulators, e.g. with patch electrodes
    • A61N1/3603—Control systems
    • A61N1/36034—Control systems specified by the stimulation parameters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • C—CHEMISTRY; METALLURGY
    • C09—DYES; PAINTS; POLISHES; NATURAL RESINS; ADHESIVES; COMPOSITIONS NOT OTHERWISE PROVIDED FOR; APPLICATIONS OF MATERIALS NOT OTHERWISE PROVIDED FOR
    • C09J—ADHESIVES; NON-MECHANICAL ASPECTS OF ADHESIVE PROCESSES IN GENERAL; ADHESIVE PROCESSES NOT PROVIDED FOR ELSEWHERE; USE OF MATERIALS AS ADHESIVES
    • C09J11/00—Features of adhesives not provided for in group C09J9/00, e.g. additives
    • C09J11/02—Non-macromolecular additives
    • C09J11/04—Non-macromolecular additives inorganic
    • C—CHEMISTRY; METALLURGY
    • C09—DYES; PAINTS; POLISHES; NATURAL RESINS; ADHESIVES; COMPOSITIONS NOT OTHERWISE PROVIDED FOR; APPLICATIONS OF MATERIALS NOT OTHERWISE PROVIDED FOR
    • C09J—ADHESIVES; NON-MECHANICAL ASPECTS OF ADHESIVE PROCESSES IN GENERAL; ADHESIVE PROCESSES NOT PROVIDED FOR ELSEWHERE; USE OF MATERIALS AS ADHESIVES
    • C09J9/00—Adhesives characterised by their physical nature or the effects produced, e.g. glue sticks
    • C09J9/02—Electrically-conducting adhesives
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F28—HEAT EXCHANGE IN GENERAL
    • F28F—DETAILS OF HEAT-EXCHANGE AND HEAT-TRANSFER APPARATUS, OF GENERAL APPLICATION
    • F28F21/00—Constructions of heat-exchange apparatus characterised by the selection of particular materials
    • F28F21/02—Constructions of heat-exchange apparatus characterised by the selection of particular materials of carbon, e.g. graphite
    • H—ELECTRICITY
    • H01—ELECTRIC ELEMENTS
    • H01L—SEMICONDUCTOR DEVICES NOT COVERED BY CLASS H10
    • H01L23/00—Details of semiconductor or other solid state devices
    • H01L23/34—Arrangements for cooling, heating, ventilating or temperature compensation ; Temperature sensing arrangements
    • H01L23/36—Selection of materials, or shaping, to facilitate cooling or heating, e.g. heatsinks
    • H01L23/373—Cooling facilitated by selection of materials for the device or materials for thermal expansion adaptation, e.g. carbon

Definitions

  • TFields Tumor Treating Fields (TTFields) therapy is a proven approach for treating tumors using alternating electric fields at frequencies between 50 kHz and 1 MHz, such as, for example, 100-500 kHz.
  • the alternating electric fields are induced by electrode assemblies (e.g., arrays of capacitively coupled electrodes, also called transducer arrays) placed on opposite sides of the subject’s body.
  • electrode assemblies e.g., arrays of capacitively coupled electrodes, also called transducer arrays
  • an AC current is coupled through the electrode assemblies and into the subject’s body. And higher currents are strongly correlated with higher efficacy of treatment.
  • FIG. 1 A is a schematic representation of a prior art electrode assembly 40 including nine prior art electrode elements, labeled X1-X9.
  • FIG. IB is a cross sectional schematic view of electrode elements X7-X9 of the electrode assembly 40, taken along the dashed line in FIG. 1 A.
  • electrode element X7 (taken as exemplary) includes a metal layer (shown with diagonal hatching) and a ceramic (dielectric) layer.
  • a respective layer of electrically conductive hydrogel is provided between each ceramic layer and the subject’s skin, to ensure good electrical contact of the electrode elements with the body.
  • An AC voltage from an AC voltage generator (not shown) is applied to the metal layers of electrode elements in opposing electrode assemblies to generate the TTFields in the subject’s body.
  • the hydrogel and the skin under the electrode elements heat up, and safety considerations require that the skin temperature remain below a safety threshold (e.g., 41° C). Because the vast majority of the heat appears immediately below the electrode elements XI -X9 (as shown in FIG. 1C), the prior art electrode assembly has hot spots immediately below the electrode elements, and cooler regions positioned between the electrode elements. And those hot spots limit the amount of current that can be delivered through the prior art electrode assemblies.
  • a safety threshold e.g. 41° C
  • One aspect of the invention is directed to a first apparatus for applying an alternating electric field to a subject’s body.
  • the first apparatus comprises a sheet of graphite having a front face and a rear face; at least one layer of conductive material disposed on the front face of the sheet, the at least one layer of conductive material having a biocompatible front surface; and a first electrode element positioned behind the sheet.
  • the first electrode element has a first front face disposed in electrical contact with the rear face of the sheet.
  • the first electrode element comprises (i) a first layer of dielectric material having a front face and a rear face and (ii) a first layer of metal disposed on the rear face of the first layer of dielectric material.
  • the front face of the first layer of dielectric material is the first front face of the first electrode element.
  • These embodiments further comprise a first rear layer of conductive material positioned between the first front face of the first electrode element and the rear face of the sheet. The first rear layer of conductive material facilitates the electrical contact between the first front face of the first electrode element and the rear face of the sheet.
  • the first apparatus further comprise a second electrode element positioned behind the sheet.
  • the second electrode element has a second front face disposed in electrical contact with the rear face of the sheet.
  • the second electrode element comprises (i) a second layer of dielectric material having a front face and a rear face and (ii) a second layer of metal disposed on the rear face of the second layer of dielectric material.
  • the front face of the second layer of dielectric material is the second front face of the second electrode element.
  • the first rear layer of conductive material is positioned between the second front face of the second electrode element and the rear face of the sheet. And the first rear layer of conductive material facilitates the electrical contact between the second front face of the second electrode element and the rear face of the sheet.
  • the first apparatus further comprise a second electrode element positioned behind the sheet.
  • the second electrode element has a second front face disposed in electrical contact with the rear face of the sheet.
  • the second electrode element comprises (i) a second layer of dielectric material having a front face and a rear face and (ii) a second layer of metal disposed on the rear face of the second layer of dielectric material.
  • the front face of the second layer of dielectric material is the second front face of the second electrode element.
  • the apparatus further comprises a second rear layer of conductive material positioned between the second front face of the second electrode element and the rear face of the sheet. The second rear layer of conductive material facilitates the electrical contact between the second front face of the second electrode element and the rear face of the sheet.
  • the first rear layer of conductive material comprises conductive hydrogel. In some embodiments of the first apparatus, the first rear layer of conductive material comprises a conductive adhesive. In some embodiments of the first apparatus, the first layer of conductive material comprises a conductive adhesive that comprises an adhesive polymer and carbon powder, particles, fibers, flakes or nanotubes. In some embodiments of the first apparatus, the first layer of conductive material comprises a conductive adhesive that has a thickness between 10 and 2,000 pm.
  • the first electrode element comprises a piece of metal having a front face, and the front face of the piece of metal is the first front face of the first electrode element.
  • the first electrode element comprises a piece of metal having a front face, and the front face of the piece of metal is the first front face of the first electrode element.
  • These embodiments further comprise a first rear layer of conductive material positioned between the first front face of the first electrode element and the rear face of the sheet. The first rear layer of conductive material facilitates the electrical contact between the first front face of the first electrode element and the rear face of the sheet.
  • the first electrode element comprises a piece of metal having a front face, and the front face of the piece of metal is the first front face of the first electrode element.
  • the first front face of the first electrode element is positioned in direct contact with the rear face of the sheet.
  • the sheet of graphite is a sheet of pyrolytic graphite. In some embodiments of the first apparatus, the sheet of graphite is a sheet of graphite foil made from compressed high purity exfoliated mineral graphite or graphitized polymer film.
  • the at least one layer of conductive material comprises hydrogel. In some embodiments of the first apparatus, the at least one layer of conductive material comprises a layer of hydrogel with a thickness between 50 and 2000 pm. In some embodiments of the first apparatus, the at least one layer of conductive material comprises a conductive adhesive. In some embodiments of the first apparatus, the front layer of biocompatible conductive material comprises a conductive adhesive and the conductive adhesive comprises an adhesive polymer and carbon powder, particles, fibers, flakes or nanotubes. In some embodiments of the first apparatus, the front layer of biocompatible conductive material comprises a conductive adhesive with a thickness between 10 and 2,000 pm.
  • Some embodiments of the first apparatus further comprise a flexible self- adhesive backing configured to support the sheet, the first electrode element, and the at least one layer of conductive material so that the front surface of the at least one layer of conductive material can be positioned against a subject’s skin. Some embodiments of the first apparatus further comprise a lead that is electrically connected to the first electrode element.
  • Another aspect of the invention is directed to a first method of applying an alternating electric field to a target region in a subject’s body.
  • the first method comprises positioning a first electrode assembly at a first position on or in the subject’s body.
  • the first electrode assembly includes a first sheet of graphite having a first front face and a first rear face, and the first electrode assembly is positioned so that the first front face of the first sheet faces the target region.
  • the first method also comprises positioning a second electrode assembly at a second position on or in the subject’s body.
  • the second electrode assembly includes a second sheet of graphite having a second front face and a second rear face, and the second electrode assembly is positioned so that the second front face of the second sheet faces the target region.
  • the first method also comprises applying an alternating voltage between the first electrode assembly and the second electrode assembly. The applying is performed after positioning the first electrode assembly and the second electrode assembly.
  • the applying is implemented by applying the alternating voltage between (i) a first electrode element disposed in electrical contact with the first rear face and (ii) a second electrode element disposed in electrical contact with the second rear face.
  • these instances may further comprise measuring a first temperature of the first electrode element; measuring a second temperature of the second electrode element; and controlling the applying based on the first temperature and the second temperature.
  • the first electrode assembly further includes a first layer of conductive adhesive disposed on the first front face
  • the second electrode assembly further includes a second layer of conductive adhesive disposed on the second front face.
  • each of the first and second sheets of graphite is a sheet of pyrolytic graphite. In some instances of the first method, each of the first and second sheets of graphite is a sheet of graphite foil made from compressed high purity exfoliated mineral graphite or graphitized polymer film.
  • FIG. 1 A is a schematic representation of a prior art electrode assembly.
  • FIG. IB is a cross sectional view of electrode elements of the prior art electrode assembly, taken along the dashed line in FIG. 1 A.
  • FIG. 1C is a cross sectional view showing the heat generation properties of a prior art electrode element.
  • FIG. ID is a cross sectional view showing the heat generation properties of a hypothetical modification to the FIG. IB electrode element.
  • FIG. 2 is a plan schematic representation of an electrode assembly including electrode elements that is used for applying TTFields to a subject’s body.
  • FIG. 3 A is a cross sectional representation of a first embodiment including electrode elements El, E2, taken along the dashed line in FIG. 2.
  • FIG. 3B is a cross sectional view showing the heat generation properties of the FIG. 3A embodiment.
  • FIG. 4A is a thermal image of a prior art electrode assembly.
  • FIG. 4B is a thermal image of an electrode assembly corresponding to the FIG. 3A embodiment.
  • FIG. 4C is a graph comparing the thermal properties of the prior art electrode assembly with the FIG. 3 A embodiment.
  • FIG. 4D shows a thermal camera image of simulated electrodes arrays built using metal (aluminum) sheets.
  • FIG. 4E shows a thermal camera image of simulated electrodes arrays built using sheets of pyrolytic graphite.
  • FIG. 4F depicts experimental results when electrode arrays with and without a sheet of graphite were used to apply TTFields to the torso of rats.
  • FIG. 5 is a cross sectional representation of a second embodiment including electrode elements El, E2, taken along the dashed line in FIG. 2.
  • FIG. 6 is a cross sectional representation of a third embodiment that includes a single electrode element El.
  • FIG. 7 is a cross sectional representation of a fourth embodiment that includes a single electrode element El.
  • FIG. 8 is a cross sectional representation of a fifth embodiment that includes a single electrode element El.
  • FIG. 9 is a block diagram of a system incorporating two electrode assemblies that is used for applying TTFields to a subject’s body.
  • This application describes exemplary electrode assemblies that may be used, e.g., for delivering TTFields to a subject’s body and treating one or more cancers or tumors located in the subject’s body.
  • TTFields When TTFields are applied to a subject’s body, the temperature at the subject’s body may increase proportionally to the induced electric field. Regulations limit the amount of current that can be driven through a transducer array to an amount that keeps the measured temperature at locations on the subject’s body below a temperature threshold.
  • the temperature at the location of the transducer arrays on the subject’s body is controlled to be below the temperature threshold by reducing the operational current driven by the transducer arrays and reducing the strength of the resulting TTFields.
  • transducer arrays that comprise multiple electrode elements the portions of the transducer arrays positioned directly beneath the electrode elements get hotter than the portions of the transducer arrays positioned between the electrode elements. Furthermore, on transducer arrays that comprise multiple electrode elements, higher currents flow through the electrode elements located along the edge of the array compared to the electrode elements located toward the middle of the array. Further still, an electrode element located at a corner or similar sharp bend in the edge of the array will have a higher current than other electrode elements along the edge and near the center of the array. The tendency of a transducer array to drive higher currents through electrode elements located along the edge of the array, and particularly at the comers, is referred to herein as the “edge effect.”
  • hot spots are the locations that reach the threshold temperature first and therefore control the requirement to reduce the current. As such, the generation of hot spots limits the maximum operational current that may be driven by a transducer array, and the strength of the resulting TTFields.
  • the inventors have now recognized that a need exists for transducer arrays that reduce or minimize uneven distribution of current and thereby allow the application of higher operating currents.
  • Transducer arrays operated with increased current can induce stronger TTFields in the subject’s body, ultimately leading to better patient outcomes.
  • the electrode assemblies disclosed herein allow current and heat to be spread evenly over the array thereby minimizing or eliminating hot spots.
  • the embodiments described herein incorporate a sheet of graphite into the electrode assembly, as described below. This lowers the temperature of the hot spots and raises the temperature of the cooler regions when a given AC voltage is applied to the electrode assembly (as compared to the prior art configuration described above). Accordingly, the current can be increased (thereby increasing the therapeutic effect) without exceeding the safety temperature threshold at any point on the subject’s skin.
  • the sheet of graphite is a sheet of pyrolytic graphite.
  • graphite is nonmetallic, it advantageously prevents the transfer of ions into a subject’s body.
  • FIG. 2 is a schematic representation of an electrode assembly 50 of an embodiment including electrode elements used for applying TTFields to a subject’s body.
  • FIG. 2 only two electrode elements labeled El and E2 are shown, but additional electrode elements may be included in the electrode assembly 50.
  • the electrode assembly 50 includes only a single electrode element.
  • FIG. 2 depicts an electrode assembly 50 generically, and those electrode assemblies El and E2 can have different configurations (e.g., as described below in connection with FIGS. 3A-8).
  • FIG. 3 A is a cross sectional representation of a first embodiment of an electrode assembly 50a including electrode elements El, E2, taken along the dashed line in FIG. 2.
  • the electrode assembly 50a includes a sheet of pyrolytic graphite 70 having a front face (facing towards the subject’s skin in FIG. 3 A) and a rear face.
  • suitable forms of graphite include synthetic graphite, such as pyrolytic graphite (including, but not limited to, Pyrolytic Graphite Sheet (PGS), available from Panasonic Industry, Kadoma, Osaka, Japan), other forms of synthetic graphite, including but not limited to, graphite foil made from compressed high purity exfoliated mineral graphite (including, but not limited to, that supplied by MinGraph® 2010A Flexible Graphite, available from Mineral Seal Corp., Arlington, Arizona, USA), or graphitized polymer film, e.g., graphitized polyimide film, (including, but not limited to, that supplied by Kaneka Corp., Moka, Tochigi, Japan.
  • synthetic graphite such as pyrolytic graphite (including, but not limited to, Pyrolytic Graphite Sheet (PGS), available from Panasonic
  • the electrode assembly 50a further includes at least one layer of conductive material 60 disposed on the front face of the sheet 70, and the at least one layer of conductive material 60 has a biocompatible front surface.
  • the at least one layer of material 60 is configured to ensure good electrical contact between the device and the body.
  • the at least one layer of material 60 should cover the entire front face of the sheet of pyrolytic graphite 70.
  • the at least one layer of material 60 may be the same size or larger than the sheet of pyrolytic graphite 70. In some embodiments (and as shown in FIG.
  • the at least one layer of conductive material 60 comprises a single layer of hydrogel.
  • the hydrogel may have a thickness between 50 and 2000 pm, such as, from 100 to 1000 pm, or even 300 to 500 pm.
  • the at least one layer of conductive material 60 is a single layer of non-hydrogel biocompatible conductive adhesive.
  • the at least one layer of conductive material 60 is a single layer of non-hydrogel biocompatible conductive adhesive such as the developmental product FLX068983 - FLEXcon® OMNI-WAVETM TT 200 BLACK H-502 150 POLY H-9 44PP-8 from FLEXcon, Spencer, MA, USA, or other such OMNI-WAVE products from FLEXcon; or ARcare® 8006 electrically conductive adhesive composition manufactured and sold by Adhesives Research, Inc. (Glen Rock, PA, USA).
  • Non-hydrogel conductive adhesives may comprise a waterless polymer with adhesive properties and carbon particles, powder, fibers, flakes or nanotubes.
  • the adhesive polymer may be, for example, an acrylic polymer or a silicone polymer, or combination thereof, which may be available as acrylic- or silicone- based carbon-filled adhesive tapes.
  • the adhesive may additionally include one or more conductive polymer (such as, for example, polyaniline (PANI) or poly(3,4- ethylenedi oxy thiophene (PEDOT), or others known in the art).
  • PANI polyaniline
  • PEDOT poly(3,4- ethylenedi oxy thiophene
  • the conductive filler in the at least one layer of conductive material 60 should be non-metallic.
  • the biocompatible conductive adhesive may have a thickness between 10 and 2,000 pm, such as, from 20 to 1000 pm, or even 30 to 400 pm.
  • the electrode assembly 50a further includes a first electrode element El positioned behind the sheet 70.
  • the first electrode element El has a first front face disposed in electrical contact with the rear face of the sheet 70.
  • the first electrode element El includes a first layer of dielectric (e.g., ceramic) material 310 having a front face and a rear face, and a first layer of metal 320 disposed on the rear face of the first layer of dielectric material 310.
  • the front face of the first layer of dielectric material 310 is the first front face of the first electrode element El. Note that while the figures (e.g., FIG.
  • dielectric material 310 depicts the dielectric material 310 as “ceramic,” a variety of other suitable dielectric materials may be used instead of ceramic materials. Examples include a polymer layer that has a dielectric constant of at least 10, or another material having a dielectric constant of at least 10.
  • the layer of dielectric material 310 can have a dielectric constant ranging from 10 to 50,000.
  • the layer of dielectric material 310 comprises a high dielectric polymer material such as poly(vinylidene fluoride- trifluoroethylene-chlorotrifluoroethylene) and/or poly(vinylidene fluoride-trifluoroethylene- 1 -chlorofluoroethylene).
  • Those two polymers are abbreviated herein as “Poly(VDF-TrFE- CTFE)” and “Poly(VDF-TrFE-CFE),” respectively. These embodiments are particularly advantageous because the dielectric constant of these materials is on the order of 40.
  • the polymer layer can be poly(vinylidene fluoride-trifluoroethylene- chlorotrifluoroethylene-chlorofluoroethylene) or “Poly(VDF-TrFE-CTFE-CFE).”
  • the layer of dielectric material 310 comprises a terpolymer comprising polymerized units of monomers such as VDF, TrFE, CFE and/or CTFE in any suitable molar ratio.
  • Suitable terpolymers include those, for example, having 30 to 80 mol% VDF, 5 to 60 mol% TrFE, with CFE and/or CTFE constituting the balance of the mol% of the terpolymer.
  • the sheet 70 has a centroid, and the centroid of the first front face of the first electrode element El is positioned less than 3 cm away from the centroid of the sheet 70. In some embodiments, the sheet 70 has a centroid and a dimension parallel to the rear face of the sheet 70 (e.g., a length or a width), and the centroid of the first front face of the first electrode element El is positioned away from the centroid of the sheet 70 by less than 30%, or by less than 10% of the dimension.
  • the electrode assembly 50a further includes a first rear layer of conductive material 80 positioned between the first front face of the first electrode element El (i.e., the front face of the first layer of dielectric material 310) and the rear face of the sheet 70.
  • the first rear layer of conductive material 80 facilitates the electrical contact between the first front face of the first electrode element El and the rear face of the sheet 70.
  • the rear layer of conductive material 80 is a layer of hydrogel. But in alternative embodiments, a different conductive material (e.g., conductive grease, conductive adhesive, conductive tape, conductive composite, etc.) could be used.
  • the conductive material 80 may be a non-hydrogel conductive adhesive, such as described above.
  • the electrode assembly 50a may optionally include one or more additional electrode elements.
  • the electrode assembly 50a includes a second electrode element E2 positioned behind the sheet 70.
  • the second electrode element E2 has a second front face disposed in electrical contact with the rear face of the sheet 70.
  • the two electrode elements El, E2 in FIG. 3A have identical structures.
  • the second electrode element E2 includes a second layer of dielectric (e.g., ceramic) material 310 having a front face and a rear face, and a second layer of metal 320 disposed on the rear face of the second layer of dielectric material 310.
  • the front face of the second layer of dielectric material 310 is the second front face of the second electrode element E2.
  • the collective area of all the electrode elements is less than the area of the sheet 70, less than half the area of the sheet 70, less than one quarter the area of the sheet 70, or less than one tenth the area of the sheet 70.
  • the first rear layer of conductive material 80 is positioned between the second front face of the second electrode element E2 (i.e., the front face of the second layer of dielectric material 310) and the rear face of the sheet 70.
  • the first rear layer of conductive material 80 facilitates the electrical contact between the second front face of the second electrode element E2 and the rear face of the sheet 70. As described for El, and as shown in FIG.
  • the conductive material 80 may be a layer of hydrogel, but in alternative embodiments, a different conductive material may be used (e.g., conductive grease, conductive adhesive including the non-hydrogel conductive adhesive described above, conductive tape, conductive composite, etc.).
  • a different conductive material e.g., conductive grease, conductive adhesive including the non-hydrogel conductive adhesive described above, conductive tape, conductive composite, etc.
  • the metal layers 320 of all of the electrode elements may be wired together (e.g., using wires, traces on a flex circuit, etc.) to a lead 90.
  • the lead 90 supplies an AC voltage from an AC voltage generator (not shown) to the electrode elements to generate the TTFields when the electrode assembly 50a is affixed to the subject’s body for treatment.
  • the electrode assembly 50a includes a flexible self-adhesive backing 55 configured to support the sheet 70, the first electrode element El (and any other electrode elements present in the electrode assembly), and the at least one layer of conductive material 60 so that the at least one layer of conductive material 60 can be positioned against the subject’s skin.
  • FIG. 2 is a plan schematic representation of an electrode assembly 50 including electrode elements El, E2.
  • This view of FIG. 2 (not to scale) also demonstrates that the area of the sheet 70 is larger (e.g., at least 2 times larger, at least 4 times larger, or at least 10 times larger) than the combined areas of the electrode elements El, E2.
  • an AC voltage is applied to the electrode elements El, E2 heat spreads out across the entire sheet 70, which minimizes or eliminates hot spots.
  • FIG. 1C shows the current distribution and heat generation for prior art electrode elements, each of which is positioned on a conductive hydrogel layer that covers about the same area as the electrode element. As shown in FIG. 1C, all the current passes through the hydrogel layer directly beneath the electrode elements, which results in hot spots directly beneath the electrode elements.
  • FIG. ID shows the current distribution and heat generation for this hypothetical electrode assembly. As shown in FIG. ID, all the current still passes through the hydrogel layer directly beneath the electrode elements, which results in hot spots directly beneath the electrode elements.
  • FIG. 3B shows the current distribution for the FIG. 3 A embodiment.
  • the current is still distributed in the rear conductive material layer (for example, 80 in FIG. 3B) only in the area below the electrode element.
  • the sheet of pyrolytic graphite 70 spreads the heat out across its entire area because the thermal conductivity in the horizontal directions is high.
  • the low electrical resistance of the sheet 70 in the horizontal direction spreads the current outward throughout the sheet 70, and this spread-out current distribution continues in the layer of conductive material 60, and thence to the subject’s skin.
  • the current and heat in this embodiment are both spread out over a larger area of the layer of conductive material 60, hotspots are eliminated (or at least minimized).
  • the hottest point beneath the electrode assembly in the FIG. 3A/B embodiment will have a lower temperature than the hottest point beneath the electrode assembly in the FIG. 1 prior art example.
  • the current can be increased (with respect to the prior art current) without exceeding the safety temperature threshold at any point beneath the electrode assembly in the FIG. 3 A embodiment.
  • this increase in current will advantageously increase the efficacy of the TTFields treatment. Similar results can be achieved when the hydrogel is replaced with a conductive adhesive composite.
  • FIG. 4A is a thermal image of a prior art electrode assembly that includes two electrode elements and a layer of hydrogel disposed on the front faces of the electrode elements. There is no sheet of graphite between the front faces of the electrode elements and the rear face of the layer of hydrogel. In use, the front face of the layer of hydrogel is positioned on the subject’s skin.
  • FIG. 4A shows hot spots generated in the areas that correspond to the electrode elements.
  • FIG. 4B is a thermal image of an electrode assembly corresponding to the FIG.
  • FIG. 4B shows that hot spots such as those generated in the prior art electrode assembly have been minimized, and also that the maximum temperature has been reduced.
  • FIG. 4C is a graph comparing the thermal performance of the FIG. 3 A embodiment (with pyrolytic graphite) with the prior art (no graphite) for the same applied current (500 mA). Notably, the hottest portion of the prior art electrode assembly was 41° C. But when the same 500 mA current was applied to the FIG. 3 A embodiment, the hottest portion of the electrode assembly was only 32° C. Similar experiments were performed utilizing graphite foil made from compressed high purity exfoliated mineral graphite, with similar results.
  • An experimental simulation of electrodes for treating a target location in a body compared the heat distribution obtained using graphite sheets to the heat distribution obtained using metal sheets.
  • a phantom gel was placed sandwiched between two sheets of metal (aluminum) and a voltage was applied (directly to the center of the sheet) between the two metal sheets.
  • a phantom gel was placed sandwiched between two sheets of pyrolytic graphite and a voltage was applied (directly to the center of the sheet) between the two pyrolytic graphite sheets.
  • FIGS. 4D and 4E respectively show thermal camera images of the simulated electrodes arrays built using metal (aluminum) sheets and the simulated electrodes arrays built using sheets of pyrolytic graphite.
  • the aluminum sheet results in an uneven heat distribution map which causes the outer edges to reach the threshold temperature first and therefore control the requirement to reduce the current.
  • the sheet of pyrolytic graphite produces a very even heat distribution across the entire sheet.
  • FIG. 4F depicts experimental results when electrode arrays with and without a sheet of graphite were used to apply TTFields to the torso of rats (using small animal arrays).
  • the two lower traces show the measured current for two rats when the prior art electrode arrays depicted in FIG. 1 A/1B were used, while the two upper traces show the measured current for two rats when the electrode elements depicted in FIG. 3 A were used (using sheets of graphite).
  • the thermal setpoint was identical for all runs.
  • the sheet of graphite was included, the improved heat and current distribution attributable to the graphite resulted in resistances that were 20% lower and currents that were 50% higher for the same thermal setpoint. And because higher currents are associated with improved outcomes, these experiments show that incorporating a layer of graphite into the electrode arrays can provide improved outcomes.
  • FIG. 5 is a cross sectional representation of a second embodiment of an electrode assembly 50b including electrode elements El, E2, taken along the dashed line in FIG. 2.
  • the FIG. 5 embodiment is similar to the FIG. 3 A embodiment in all respects (including the figure labeling) except as follows.
  • the FIG. 3 A embodiment includes a large rear layer of conductive material 80 (e.g., hydrogel) positioned between the sheet 70 and the front faces of both the first and second electrode elements El and E2.
  • the FIG. 5 embodiment includes a separate region of conductive material 380 for each individual electrode element.
  • the 5 embodiment includes a first rear layer of conductive material 380 positioned between the first front face of the first electrode element El and the rear face of the sheet 70, and also includes a second rear layer of conductive material 380 positioned between the second front face of the second electrode element E2 and the rear face of the sheet 70.
  • the first and second rear layers of conductive material 380 facilitate the electrical contact between the respective electrode front faces and the rear face of the sheet 70.
  • the rear layers of conductive material 380 are layers of hydrogel. But in alternative embodiments, different conductive materials (e.g., conductive grease, conductive adhesive including the non-hydrogel conductive adhesives discussed above, conductive tape, conductive composite, etc.) could be used.
  • the collective area of all the electrode elements is less than the area of the sheet 70, less than half the area of the sheet 70, less than one quarter the area of the sheet 70, or less than one tenth the area of the sheet 70.
  • the current in the FIG. 5 embodiment is still concentrated in the rear layers of conductive material 380 only in the areas below the electrode elements.
  • the sheet of pyrolytic graphite 70 spreads out the heat and the current as described above in connection with the FIG. 3 A embodiment, which eliminates or at least minimizes hot spots.
  • the current can be increased (with respect to the prior art current) without exceeding the safety temperature threshold at any point beneath the electrode assembly in the FIG. 5 embodiment. And this increase in current will advantageously increase the efficacy of the TTFields treatment.
  • FIG. 6 is a cross sectional representation of a third embodiment of an electrode assembly 50c that includes a single electrode element El.
  • the embodiment of FIG. 6 is similar to the embodiment of FIG. 3 A except the FIG. 6 embodiment does not include the layer of dielectric material.
  • the electrode assembly 50c includes a sheet of pyrolytic graphite 70 having a front face (facing towards the subject’s skin in FIG. 6) and a rear face. This sheet 70 is similar to the sheet 70 described above in connection with FIG. 3A.
  • the electrode assembly 50c further includes at least one layer of conductive material 60 disposed on the front face of the sheet 70, and the at least one layer of conductive material 60 has a biocompatible front surface.
  • the at least one layer of conductive material 60 is configured to ensure good electrical contact between the device and the body. In a preferred embodiment, the at least one layer of conductive material 60 should cover the entire front face of the sheet of pyrolytic graphite 70.
  • the at least one layer of conductive material 60 may be the same size or larger (i.e., cover the same area or larger) than the sheet of pyrolytic graphite 70.
  • the at least one layer of conductive material 60 comprises a single layer of hydrogel.
  • the hydrogel may have a thickness between 50 and 2000 pm, such as, from 100 to 1000 pm, or even 300 to 500 pm.
  • the at least one layer of conductive material 60 is a single layer of nonhydrogel biocompatible conductive adhesive as discussed above.
  • the at least one layer of conductive material 60 is a single layer of non-hydrogel biocompatible conductive adhesive such as the OMNI-WAVE products from FLEXcon or the ARcare® products from Adhesives Research, Inc., discussed above.
  • Non-hydrogel conductive adhesives may comprise a waterless polymer with adhesive properties (for example, an acrylic polymer or a silicone polymer, or combination thereof) and a conductive filler.
  • the conductive filler in the at least one layer of conductive material 60 should be non-metallic.
  • the biocompatible conductive adhesive may have a thickness between 10 and 2,000 pm, such as, from 20 to 1000 pm, or even 30 to 400 pm.
  • the electrode assembly 50c further includes a first electrode element El positioned behind the sheet 70.
  • the first electrode element El includes a piece of metal 500 having a front face disposed in electrical contact with the rear face of the sheet 70.
  • the front face of the piece of metal 500 is the first front face of the first electrode element El.
  • the FIG. 6 embodiment differs from the FIG. 3 A or FIG. 5 embodiments by lacking a layer of dielectric material.
  • the positional relationship between the first electrode element El and the sheet 70 in this FIG. 6 embodiment may be as described above in connection with FIG. 3 A.
  • the electrode assembly 50c further includes a first rear layer of conductive material 80 positioned between the first front face of the first electrode element El (i.e., the front face of the piece of metal 500) and the rear face of the sheet 70.
  • the first rear layer of conductive material 80 facilitates the electrical contact between the first front face of the first electrode element El and the rear face of the sheet 70.
  • the rear layer of conductive material 80 is a layer of hydrogel.
  • a different conductive material e.g., conductive grease, conductive adhesive including the non-hydrogel conductive adhesive described above, conductive tape, conductive composite, etc. could be used.
  • the piece of metal 500 of the electrode element El is wired (e.g., using wires, traces on a flex circuit, etc.) to a lead 90, which supplies an AC voltage from an AC voltage generator (not shown) to the electrode element to generate the TTFields when the electrode assembly 50c is affixed to the subject’s body for treatment.
  • a lead 90 which supplies an AC voltage from an AC voltage generator (not shown) to the electrode element to generate the TTFields when the electrode assembly 50c is affixed to the subject’s body for treatment.
  • the electrode assembly 50c may optionally include one or more additional electrode elements (not shown) having a structure identical to electrode element El and positioned to have the same functionality.
  • the pieces of metal 500 of all the electrode elements may be wired together (e.g., using wires, traces on a flex circuit, etc.) to the lead 90.
  • the area of the sheet 70 is larger (e.g., at least 2 times larger, at least 4 times larger, or at least 10 times larger) than the area of the electrode element El.
  • the area of the sheet 70 is larger (e.g., at least 2, 4, or 10 times larger) than the collective area of all of the electrode elements.
  • the sheet of pyrolytic graphite 70 in the FIG. 6 embodiment spreads out the heat and the current as described above in connection with the FIG. 3 A embodiment, which eliminates or at least minimizes hot spots.
  • the hottest point beneath the electrode assembly in the FIG. 6 embodiment will have a lower temperature than the hottest point beneath the electrode assembly in the FIG. 1 prior art example.
  • the current can be increased (with respect to the prior art current) without exceeding the safety temperature threshold at any point beneath the electrode assembly in the FIG. 6 embodiment. And this increase in current will advantageously increase the efficacy of the TTFields treatment.
  • FIG. 7 is a cross sectional representation of a fourth embodiment of an electrode assembly 50d that includes a single electrode element El.
  • the FIG. 7 embodiment is similar to the FIG. 6 embodiment except that the first front face of the first electrode element El (i.e., the front face of the piece of metal 600) is positioned in direct contact with the rear face of the sheet 70 (instead of being electrically connected via an intervening layer of conductive material).
  • the sheet of pyrolytic graphite 70 in the FIG. 7 embodiment spreads out the heat and the current as described above in connection with the FIG. 3 A embodiment, which eliminates or at least minimizes hot spots. This means that for a given applied AC voltage, the hottest point beneath the electrode assembly in the FIG.
  • the current can be increased (with respect to the prior art current) without exceeding the safety temperature threshold at any point beneath the electrode assembly in the FIG. 7 embodiment. And this increase in current will advantageously increase the efficacy of the TTFields treatment.
  • FIG. 8 is a cross sectional representation of a fifth embodiment of an electrode assembly 50e that includes a single electrode element El.
  • the FIG. 8 embodiment is similar to the FIG. 7 embodiment, but it adds a capacitor 700 connected in series with and behind the piece of metal 600.
  • a similar addition of a capacitor 700 connected in series with and behind the piece of metal 600 could also be envisioned for the FIG. 6 embodiment.
  • FIG. 9 shows how a pair of the FIG. 3 A electrode assemblies 50a may be used to apply an alternating electric field to a target region in the subject’s body.
  • the subject could be a human or another mammal, including but not limited to rats and mice. (Note that any of the electrode assemblies described above in connection with FIGS. 5-8 may be used instead of the FIG. 3 A electrode assemblies 50a shown here).
  • the method includes positioning a first electrode assembly 50a at a first position on or in the subject’s body.
  • the first electrode assembly 50a is positioned on the subject’s skin at the right of the subject’s head facing a target region, e.g., a tumor.
  • the first electrode assembly 50a may be constructed as described earlier herein.
  • the first electrode assembly 50a includes a first sheet 70 of pyrolytic graphite 70 having a first front face and a first rear face. During use, the first electrode assembly 50a is positioned so that the first front face of the first sheet 70 faces the target region.
  • the method also includes positioning a second electrode assembly 50a at a second position in or on the subject’s body.
  • the second electrode assembly 50a is positioned on the subject’s skin at the left of the subject’s head facing the target region.
  • the second electrode assembly 50a may be constructed as described earlier herein.
  • the second electrode assembly 50a includes a second sheet 70 of pyrolytic graphite 70 having a second front face and a second rear face. During use, the second electrode assembly 50a is positioned so that the second front face of the second sheet 70 faces the target region.
  • the method further includes applying an alternating voltage between the first electrode assembly 50a and the second electrode assembly 50a.
  • the applying is performed after positioning the first electrode assembly 50a and the second electrode assembly 50a.
  • the applying may be implemented by applying the alternating voltage between (i) a first electrode element disposed in electrical contact with the first rear face of the first sheet 70 and (ii) a second electrode element disposed in electrical contact with the second rear face of the second sheet 70.
  • the first electrode assembly 50a further includes a first layer of biocompatible conductive material 60 disposed on the first front face of the first sheet 70.
  • the second electrode assembly further includes a second layer of biocompatible conductive material 60 disposed on the second front face of the second sheet 70.
  • the biocompatible conductive material 60 may be hydrogel or may be a conductive grease, conductive adhesive including the non-hydrogel conductive adhesives discussed above, conductive tape, conductive composite, etc.
  • the first electrode assembly 50a further includes a first rear layer of conductive material 80 (as described above) positioned between the first front face of the first electrode element of the first electrode assembly 50a and the first rear face of the first sheet 70.
  • the second electrode assembly further includes a second rear layer of conductive material 80 (as described above) positioned between the second front face of the second electrode element of the second electrode assembly and the second rear face of the second sheet 70.
  • the alternating voltage between the first electrode assembly and the second electrode assembly may be applied by an AC voltage generator 820.
  • the frequency of the alternating voltage is between 50 kHz and 1 MHz, or between 100 kHz and 500 kHz.
  • the AC voltage generator is controlled by a controller 822.
  • the controller 822 may use temperature measurements to control the amplitude of the current to be delivered via the first and second electrode assemblies 50a in order to maintain temperatures below a safety threshold (e.g., 41° C). This may be accomplished, for example, by measuring a first temperature of the first electrode element, measuring a second temperature of the second electrode element, and controlling the applying of the alternating voltage based on the first temperature and the second temperature, as described below.
  • FIG. 9 depicts one example of hardware that is suitable for this purpose. More specifically, temperature sensors 800 (e.g., thermistors) are positioned in thermal contact with respective electrode elements 310/320 within each of the electrode assemblies 50a. The temperature sensors 800 measure respective first and second temperatures (e.g., at first and second electrode elements in the first electrode assembly and second electrode assembly, respectively), and the controller 822 controls the output of the AC voltage generator 820 based on these temperatures.
  • first and second temperatures e.g., at first and second electrode elements in the first electrode assembly and second electrode assembly, respectively
  • the sheet 70 is made of pyrolytic graphite.
  • the sheet 70 may be made of other types of graphite, including but not limited to other synthetic graphite, such as graphite foil made from compressed high purity exfoliated mineral graphite (including but not limited to MinGraph® 2010A Flexible Graphite, available from Mineral Seal Corp., Arlington, Arizona, USA); isotropic graphite (including but not limited to isotropic graphite grade G330 available from Tokai Carbon Europe, Oldbury, UK; or double-sided carbon tape for scanning electron microscopy, available from Fisher Scientific, a unit of Thermo Fisher Scientific, Hampton, NH, USA).
  • synthetic graphite such as graphite foil made from compressed high purity exfoliated mineral graphite (including but not limited to MinGraph® 2010A Flexible Graphite, available from Mineral Seal Corp., Arlington, Arizona, USA); isotropic graphite (including but not limited to isotropic graphite grade G330 available from Tokai Carbon Europe, Oldbury, UK; or double-sided carbon tape for

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Abstract

Des champs électriques alternatifs (par exemple, des champs TTFields) peuvent être appliqués au corps d'un sujet à l'aide d'un ou plusieurs ensembles électrodes qui comprennent une feuille de graphite, au moins une couche de matériau conducteur disposée sur la face avant de la feuille de graphite et un élément d'électrode positionné derrière la feuille de graphite. L'élément d'électrode présente une face avant disposée en contact électrique avec la face arrière de la feuille de graphite. La feuille de graphite étale à la fois la chaleur et le courant dans des directions qui sont parallèles à la face avant de la feuille, ce qui élimine ou au moins réduit au minimum les points chauds sur l'ensemble électrode. Ceci permet à son tour d'augmenter le courant sans dépasser un seuil de sécurité de température (par exemple, 41 °C).
PCT/IB2022/057234 2021-08-06 2022-08-04 Ensemble électrode pour l'application de champs de traitement de tumeurs (ttchamps) comprenant une feuille de graphite WO2023012708A1 (fr)

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CN202280049637.2A CN117642208A (zh) 2021-08-06 2022-08-04 用于施加包括石墨片的肿瘤治疗场（ttfield）的电极组合件
KR1020237044278A KR20240041872A (ko) 2021-08-06 2022-08-04 Ttfield를 인가하기 위한 그라파이트의 시트를 포함하는 전극 어셈블리
CA3226310A CA3226310A1 (fr) 2021-08-06 2022-08-04 Ensemble electrode pour l'application de champs de traitement de tumeurs (ttchamps) comprenant une feuille de graphite
MX2023015427A MX2023015427A (es) 2021-08-06 2022-08-04 Conjunto de electrodos para la aplicacion de campos para tratar tumores (ttfields) que incluye una lamina de grafito.
EP22757666.7A EP4344415A1 (fr) 2021-08-06 2022-08-04 Ensemble électrode pour l'application de champs de traitement de tumeurs (ttchamps) comprenant une feuille de graphite
JP2023579833A JP2024527712A (ja) 2021-08-06 2022-08-04 黒鉛のシートを備える腫瘍治療電場（ＴＴＦｉｅｌｄｓ）を印加するための電極アセンブリ
IL309481A IL309481A (en) 2021-08-06 2022-08-04 Install electrodes for applying tumor treatment fields (TTFIELDS) that include a graphite sheet

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PCT/IB2022/057233 WO2023012707A1 (fr) 2021-08-06 2022-08-04 Ensemble électrode pour l'application de champs de traitement de tumeurs (champs tt) avec une feuille de matériau anisotrope

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US20240001134A1 (en) 2022-06-30 2024-01-04 Novocure Gmbh Adhesive layer with protective border for use in a tumor treating fields transducer
US12108563B2 (en) * 2022-07-27 2024-10-01 Toyota Motor Engineering & Manufacturing North America, Inc. Power electronics assemblies having embedded power electronics devices
US20240130093A1 (en) * 2022-10-17 2024-04-18 Toyota Motor Engineering & Manufacturing North America, Inc. Power electronics assemblies having embedded power electronics devices
WO2024141952A1 (fr) * 2022-12-29 2024-07-04 Novocure Gmbh Inhibiteur de fibroblaste (caf) associé au cancer destiné à être utilisé avec un champ électrique alternatif dans une méthode de traitement de maladies telles que le cancer
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